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Trotter C, O'Brien D, Stanton EW, Roohani I, Shakoori P, Urata MM, Hammoudeh JA. Custom Endoprosthesis-Assisted Pediatric Microsurgical Jaw Reconstruction. J Craniofac Surg 2024:00001665-990000000-01744. [PMID: 38953587 DOI: 10.1097/scs.0000000000010426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Accepted: 05/24/2024] [Indexed: 07/04/2024] Open
Abstract
Surgical treatment of pediatric maxillary and mandibular tumors can cause significant postresection disfigurement, mastication, and speech dysfunction. The need to restore form and function without compromising growth at the recipient and donor sites poses a particular reconstructive dilemma. This study evaluates outcomes of the custom endoprosthesis (CE) compared with noncustom reconstruction (NCR) and introduces an algorithm using CE to optimize available soft tissue reconstructive options. An Institutional Review Board-approved retrospective review of all patients undergoing maxillary or mandibular reconstruction between 2016 and 2022 was completed. The independent variable of interest was CE utilization. Primary outcomes of interest included hardware failure/removal or exposure, major complications, and revision surgeries. Covariates of interest included patient demographics, medical comorbidities, tumor size, and pathologic diagnosis. Statistical analyses including independent t test, χ2 analyses, and univariate/multivariate logistic regression were performed using RStudio version 4.2.1. Fifty-one patients (37 mandible and 14 maxilla) underwent CE or NCR. Of patients, 37% (n = 19) received CE. Of patients who underwent mandibular reconstruction, there were significantly lower rates of hardware exposure (14.3% versus 47.8%, P = 0.018), failure (7.1% versus 43.5%, P = 0.048), major complications (28.6% versus 78.2%, P = 0.008), and revisions (11.1% versus 50.0%, P = 0.002) in the CE cohort compared with the NCR cohort. The rates of hardware failure, exposure, major complications, and revisions did not significantly differ in maxillary reconstructions, however, CE successfully reconstructed significantly larger defects (179.5 versus 74.6 cm3, P = 0.020) than NCRs. Deviating from NCR, the authors propose an algorithm considering anatomical location, extent of resection, and patient age for soft tissue selection. This algorithm yielded improved mandibular reconstructive outcomes and no increase in complications rate in maxillary reconstruction despite larger resection defects. Furthermore, the authors' initial findings demonstrate that CE is a safe option for pediatric maxillary and mandibular reconstruction that may, in addition, facilitate improved form and function.
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Affiliation(s)
- Collean Trotter
- Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles
- Division of Plastic and Reconstructive Surgery, Keck School of Medicine
| | - Devon O'Brien
- Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles
- Division of Plastic and Reconstructive Surgery, Keck School of Medicine
| | - Eloise W Stanton
- Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles
- Division of Plastic and Reconstructive Surgery, Keck School of Medicine
| | - Idean Roohani
- Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles
- Division of Plastic and Reconstructive Surgery, Keck School of Medicine
| | - Pasha Shakoori
- Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles
| | - Mark M Urata
- Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles
- Division of Plastic and Reconstructive Surgery, Keck School of Medicine
- Division of Oral and Maxillofacial Surgery
- Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA
| | - Jeffrey A Hammoudeh
- Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles
- Division of Plastic and Reconstructive Surgery, Keck School of Medicine
- Division of Oral and Maxillofacial Surgery
- Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA
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Khattak YR, Ghaffar N, Gulzar MA, Rahim S, Rafique F, Jan Z, Iqbal S, Ahmad I. Can growing patients with end-stage TMJ pathology be successfully treated with alloplastic temporomandibular joint reconstruction? - A systematic review. Oral Maxillofac Surg 2024; 28:529-537. [PMID: 37733214 DOI: 10.1007/s10006-023-01180-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 09/08/2023] [Indexed: 09/22/2023]
Abstract
INTRODUCTION The use of alloplastic total temporomandibular joint reconstruction (TMJR) in growing patients is controversial, mainly due to immature elements of the craniomaxillofacial skeleton. The aim of this systematic review was to evaluate the use of alloplastic TMJR in growing patients, focusing on the patient's clinical presentation, surgical and medical history and efficacy of alloplastic TMJR implantation. MATERIALS AND METHODS The literature search strategy was based on the Population, Intervention, Comparator, Outcomes and Study type (PICOS) framework. We searched Pubmed, Google Scholar, Dimension, Web of Science, X-mol, Semantic Scholar and Embase to January 2023, without any restriction on the type of publication reporting alloplastic TMJR in growing patients (age ≤ 18 years for boys and age ≤ 15 years for girls). RESULTS A total of 15 studies (case reports: 09, case series: 02, cohort studies: 04) met the inclusion criteria, documenting 73 patients of growing age from 07 countries. Thirty-eight (~ 52%) cases were female. The mean ± SD (range) age and follow-up of patients in all studies was 13.1 ± 3.2 (0-17) years and 34.3 ± 21.5 (7-96) months, respectively. A total of 22 (30%) patients were implanted with bilateral alloplastic TMJR. Over half of the studies (n = 10) were published in the last 3 years. All patients underwent multiple surgeries prior to implantation of alloplastic TMJR. In extreme cases, patients underwent a total of 17 surgeries. Different types of studies reporting inconsistent variables restricted our ability to perform quality assessment measures for evidence building. CONCLUSIONS Clinical experience with alloplastic TMJR in growing patients is limited to cases showing poor prognosis with other types of reconstruction. Nevertheless, studies show promising results for the use of alloplastic TMJR in growing patients, highlighting the need for well-controlled prospective studies with long-term follow-up.
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Affiliation(s)
| | | | | | - Sundas Rahim
- Peshawar Medical and Dental College, Peshawar, Pakistan
| | | | - Zainab Jan
- Institute of Radiotherapy and Nuclear Medicine (IRNUM), Peshawar, Pakistan
| | - Shaheen Iqbal
- Institute of Radiotherapy and Nuclear Medicine (IRNUM), Peshawar, Pakistan
| | - Iftikhar Ahmad
- Institute of Radiotherapy and Nuclear Medicine (IRNUM), Peshawar, Pakistan.
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Okoturo E. Genetic determinants of periosteum-mediated craniofacial bone regeneration: a systematic review. Arch Craniofac Surg 2023; 24:251-259. [PMID: 37584066 PMCID: PMC10766501 DOI: 10.7181/acfs.2023.00381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 07/21/2023] [Accepted: 08/01/2023] [Indexed: 08/17/2023] Open
Abstract
BACKGROUND Periosteum-mediated bone regeneration (PMBR) is a recognized method for mandibular reconstruction. Despite its unpredictable nature and the limited degree to which it is understood, it does not share the concerns of developmental changes to donor and recipient tissues that other treatment options do. The definitive role of the periosteum in bone regeneration in any mammal remains largely unexplored. The purpose of this study was to identify the genetic determinants of PMBR in mammals through a systematic review. METHODS Our search methodology was designed in accordance with the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines. We conducted a quality assessment of each publication, and evaluated the differences in gene expression between days 7 and 15. RESULTS A total of four studies satisfied the inclusion criteria. The subjects and tissues examined in these studies were Wistar rat calvaria in two studies, mini-pigs in one study, and calves and mice in one study. Three out of the four studies achieved the necessary quality score of ≥ 3. Gene expression analysis showed increased activity of genes responsible for angiogenesis, cytokine activities, and immune-inflammatory responses on day 7. Additionally, genes related to skeletal development and signaling pathways were upregulated on day 15. Conclusions: The results suggest that skeletal morphogenesis is regulated by genes associated with skeletal development, and the gene expression patterns of PMBR may be characterized by specific pathways.
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Affiliation(s)
- Eyituoyo Okoturo
- Division of Head & Neck Cancer Oral, Department of Maxillofacial Surgery, Lagos State University Teaching Hospital (LASUTH), Lagos, Nigeria
- Molecular Oncology Program, Medical Research Centre, Lagos State University College of Medicine (LASUCOM), Lagos, Nigeria
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Parham MJ, Ding Y, Wang DS, Jiang AY, Buchanan EP. Pediatric Craniofacial Tumor Reconstruction. Semin Plast Surg 2023; 37:265-274. [PMID: 38098683 PMCID: PMC10718654 DOI: 10.1055/s-0043-1776330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
Effective management of pediatric craniofacial tumors requires coordinated input from medical, oncologic, and surgical specialties. Reconstructive algorithms must consider limitations in pediatric donor tissue and account for future growth and development. Immediate reconstruction is often focused on filling dead space, protecting underlying structures, and ensuring skeletal symmetry. Staged reconstruction occurs after the patient has reached skeletal maturity and is focused on restoring permanent dentition. Reconstructive options vary depending on the location, size, and composition of resected tissue. Virtual surgical planning (VSP) reduces the complexity of pediatric craniofacial reconstruction and ensures more predictable outcomes.
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Affiliation(s)
- Matthew J. Parham
- Michael E. DeBakey Department of Surgery, Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas
- Division of Plastic Surgery, Texas Children's Hospital, Houston, Texas
| | - Yang Ding
- Michael E. DeBakey Department of Surgery, Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas
- Division of Plastic Surgery, Texas Children's Hospital, Houston, Texas
| | - Daniel S. Wang
- Michael E. DeBakey Department of Surgery, Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas
- Division of Plastic Surgery, Texas Children's Hospital, Houston, Texas
| | - Austin Y. Jiang
- Michael E. DeBakey Department of Surgery, Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas
- Division of Plastic Surgery, Texas Children's Hospital, Houston, Texas
| | - Edward P. Buchanan
- Michael E. DeBakey Department of Surgery, Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas
- Division of Plastic Surgery, Texas Children's Hospital, Houston, Texas
- Division of Plastic Surgery, Texas Children's Hospital, Austin, Texas
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Walatek J, Myśliwiec A, Krakowczyk Ł, Wolański W, Lipowicz A, Dowgierd K. Planning of physiotherapeutic procedure in patients after mandible reconstruction taking into account donor site: a literature review. Eur J Med Res 2023; 28:386. [PMID: 37770987 PMCID: PMC10536701 DOI: 10.1186/s40001-023-01386-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 09/20/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND Mandible tumors are very rare. One of the main methods of the treatments is resection of the tumor and then reconstruction of the mandible. The donor site is often distant tissue-fibula or ilium. Following this, it is necessary to improve the patient in two ways, on one hand restoring the function of the mandible, and on the other hand, improving the donor site area. For that reason, physiotherapy after tumor resection and reconstruction of the mandible is very complicated. The aim of this bibliographic review was to find the methods of the reconstruction of the mandible in the context of patients' functional assessment after surgeries to create effective physiotherapeutic procedures in the feature. METHODS PEDro, Medline (PubMed), Cochrane Clinical Trials were searched. RESULTS 767 articles were found. 40 articles were included to this literature review. CONCLUSIONS Authors showed different kinds of surgeries strategy for patients with tumors of the mandible. They also showed manners of patients' functional assessment in the localization of transplantation and donor site. It could be useful for physiotherapists during planning of comprehensive physiotherapy.
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Affiliation(s)
- Julia Walatek
- Department of Science, Innovation and Development, Galen-Orthopedics, 43-150 Bierun, Poland
| | - Andrzej Myśliwiec
- Laboratory of Physiotherapy and Physioprevention, Institute of Physiotherapy and Health Sciences, Academy of Physical Education, 40-065 Katowice, Poland
| | - Łukasz Krakowczyk
- Department of Oncologic and Reconstructive Surgery, Maria Sklodowska-Curie National Research Institute of Oncology, 44-102 Gliwice, Poland
| | - Wojciech Wolański
- Department of Biomechatronics, Faculty of Biomedical Engineering, Silesian University of Technology, 41-800 Zabrze, Poland
| | - Anna Lipowicz
- Department of Anthropology, Institute of Environmental Biology, Wroclaw University of Environmental and Life Sciences, 50-375 Wroclaw, Poland
| | - Krzysztof Dowgierd
- Head and Neck Surgery Clinic for Children and Young Adults, Department of Clinical Pediatrics, University of Warmia and Mazury, 10-561 Olsztyn, Poland
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Govoni FA, Felici N, Ornelli M, Marcelli VA, Migliano E, Pesucci BA, Pistilli R. Total mandible and bilateral TMJ reconstruction combining a customized jaw implant with a free fibular flap: a case report and literature review. Maxillofac Plast Reconstr Surg 2023; 45:6. [PMID: 36689098 PMCID: PMC9871153 DOI: 10.1186/s40902-023-00374-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 01/10/2023] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND The need for whole mandibular bone reconstruction and bilateral joint replacement is fortunately rare, but it is an extremely challenging topic in maxillofacial surgery, due to its functional implications. CAD-CAM techniques development has opened new broad horizons in the surgical planning of complex maxillofacial reconstructions, in terms of accuracy, predictability, and functional cosmetic results. The review of the literature has revealed a small number of scientific reports on total mandibulectomy including the condyles, with only eleven cases from 1980. Most of the works describe reconstructions secondary to dysplastic or inflammatory diseases affecting the lower jaw. The aim of this work, reporting a rare case of massive fibrous dysplasia of the whole mandible, is to share our experience in the management of extended mandibular and bilateral joint reconstruction, using porous titanium patient-specific implants. CASE PRESENTATION The authors present a 20-year-old male patient suffering from massive bone fibrous dysplasia of the mandible. The mandibular body and both the rami and the condylar processes had been involved, causing severe functional impairment, tooth loss, and facial deformation. The young patient, after repeated ineffective conservative surgical treatments, has required a biarticular mandibular replacement. Using virtual surgical planning (VSP) software, the authors, in collaboration with medical engineers, have created a custom-made original titanium porous mandibular implant, suspended from a bilateral artificial temporomandibular joint. The mandibular titanium implant body has been specifically designed to support soft tissues and to fix, in the alveolar region, a free fibular bone graft, for delayed dental implant prosthetic rehabilitation. CONCLUSION The surgical and technical details, as well as the new trends in mandibular reconstructions using porous titanium implants, are reported, and discussed, reviewing literature reports on this topic. Satisfactory functional and cosmetic restorative results have been obtained, and no major complications have occurred. The patient, currently in the 18th month clinical and radiological follow-up, has recently completed the functional restoration program by an implant-supported full-arch dental prosthesis.
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Affiliation(s)
- Flavio Andrea Govoni
- grid.416308.80000 0004 1805 3485Unit of Maxillofacial Surgery, San Camillo-Forlanini Hospital, Rome, Italy
| | - Nicola Felici
- grid.416308.80000 0004 1805 3485Unit of Plastic and Reconstructive Surgery of the Limbs, San Camillo-Forlanini Hospital, Rome, Italy
| | - Matteo Ornelli
- grid.416308.80000 0004 1805 3485Unit of Plastic and Reconstructive Surgery of the Limbs, San Camillo-Forlanini Hospital, Rome, Italy
| | - Vincenzo Antonio Marcelli
- grid.416308.80000 0004 1805 3485Unit of Maxillofacial Surgery, San Camillo-Forlanini Hospital, Rome, Italy
| | - Emilia Migliano
- grid.419467.90000 0004 1757 4473Department of Plastic and Regenerative Surgery, San Gallicano Dermatological Institute IRCCS I.F.O, Rome, Italy
| | - Bruno Andrea Pesucci
- grid.416308.80000 0004 1805 3485Unit of Maxillofacial Surgery, San Camillo-Forlanini Hospital, Rome, Italy
| | - Roberto Pistilli
- grid.416308.80000 0004 1805 3485Unit of Maxillofacial Surgery, San Camillo-Forlanini Hospital, Rome, Italy
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Osteomyelitis Possibly Caused by Exfoliation of Primary Teeth in a Patient with Osteopetrosis. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121894. [PMID: 36553337 PMCID: PMC9776751 DOI: 10.3390/children9121894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/30/2022] [Accepted: 12/01/2022] [Indexed: 12/05/2022]
Abstract
Osteopetrosis is a rare inherited skeletal disease characterized by increased density in the bones and can be detected by radiographs. Sclerosis makes the jaw bones extremely susceptible to infections, osteomyelitis, and fractures. Here, we report a case of osteomyelitis possibly caused by spontaneous exfoliation of primary teeth in a patient with osteopetrosis. A 2 years and 9 months (2Y9M)-old boy with osteopetrosis was referred to our clinic for oral management. Only four primary central incisors had erupted, and they all exhibited hypoplasia. The mandibular right central primary incisor suddenly became exfoliated at 4 years and 1 month. The mandibular right lateral primary incisor also became exfoliated at 4 years and 3 months, soon after eruption, and the mandibular left central primary incisor became exfoliated at 4 years and 5 months. Subsequently, we confirmed the eruption of calcified tissue at 4 years and 9 months in the location where the mandibular right lateral primary incisor had become exfoliated. The patient was admitted to the pediatrics clinic for mandibular cellulitis at 5 years and 2 months, then referred to our clinic for the management of osteomyelitis. The patient's acute inflammation was reduced by repeated irrigation and the administration of antibiotics; the inflammation gradually became chronic. When treating patients with osteopetrosis, dentists and oral surgeons should prioritize infection control in the jaw, periodic assessment of dental eruption, and the maintenance of oral hygiene.
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Bansal A, Nagori SA, Chug A, Dixit A, Chowdhry R, Reddy SG. Reconstruction options in pediatric population with hemi or total mandibulectomy defects: A systematic review. J Oral Biol Craniofac Res 2022; 12:238-247. [DOI: 10.1016/j.jobcr.2022.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 02/23/2022] [Accepted: 03/14/2022] [Indexed: 12/24/2022] Open
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Outcomes following Microvascular Mandibular Reconstruction in Pediatric Patients and Young Adults. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 8:e3243. [PMID: 33299708 PMCID: PMC7722618 DOI: 10.1097/gox.0000000000003243] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 09/14/2020] [Indexed: 11/26/2022]
Abstract
Background: The etiology and treatment of complex mandibular defects in children differ markedly from those of adults, although treatment with free bone flaps is historical in both groups. While adult outcomes and complication rates are well known, few pediatric data exist, especially for patients with congenital deficiencies. This study reports early and late outcomes from a cohort of young, primarily syndromic patients undergoing microvascular mandibular reconstruction. Methods: This is a retrospective case series of patients who underwent microvascular mandibular reconstruction between 1995 and 2016. Results: Thirteen patients received a total of 13 fibula transfers and 1 medial femoral condyle transfer. Most patients carried a congenital diagnosis (77%), and the average age during surgery was 11.7 ± 5.7 years. The median (interquartile range) [IQR] length of follow-up was 6.3 (5.7) years. There was a 100% flap survival rate, although 86% of all patients experienced at least one complication. Half of all procedures resulted in an early complication. Nine patients (69%) developed late complications, of which temporal mandibular joint ankylosis was the most common (n = 5; 38%). Conclusions: This study is one of few detailing outcomes following mandibular reconstruction by free flap transfer in pediatric patients. These patients were primarily syndromic with appreciable complication rates higher than in other adult and pediatric studies. Some complications are manageable or self-resolving, but others lead to functional problems that may require late operative interventions to correct. Microsurgical treatment should be reserved for children with large, complex mandibular defects when other options are unavailable or have been exhausted.
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Cassoni A, Brauner E, Pucci R, Terenzi V, Mangini N, Battisti A, Della Monaca M, Ciolfi A, Laudoni F, Di Carlo S, Valentini V. Head and Neck Osteosarcoma-The Ongoing Challenge about Reconstruction and Dental Rehabilitation. Cancers (Basel) 2020; 12:cancers12071948. [PMID: 32708374 PMCID: PMC7409227 DOI: 10.3390/cancers12071948] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 07/08/2020] [Accepted: 07/09/2020] [Indexed: 12/27/2022] Open
Abstract
Head and Neck osteosarcoma is an uncommon disease. Hitherto, the treatment is surgical resection and survival is influenced by the presence of free margins. However, the dimension of the resection may represent a hurdle for an adequate Quality of Life (QOL). Maxillofacial district is a narrow space where the function, esthetics and patient’s relational skills fit together like the gears of a clock. The functional results depend on the type of reconstruction and prosthetic rehabilitation that are both important to guarantee a good aesthetic result and finally increase the patient’s self-esteem. This study aims to report our experience about head and neck (HN) osteosarcoma focusing the attention on reconstructive and dental-rehabilitative problems. It is a retrospective study all patients were surgically treated in our department. Subjects with histological diagnosis of HN osteosarcoma, treated between 2005 and 2017 were included. The demographic characteristics, surgical treatment, eventually secondary reconstruction and prosthetic rehabilitation, performed in the same department, have been collected. The QOL was assessed through the EORTC QLQ-H&N35 (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Head and Neck 35) questionnaire. Fifteen patients were enrolled, eight received a free flap microsurgical reconstruction. Dental rehabilitation was performed in five cases and a mobile prosthesis was always delivered. Eighteen implants were inserted in fibula bones for three patients; highly porous implants were used.
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Affiliation(s)
- Andrea Cassoni
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome; Via Caserta 6, 00161 Rome, Italy; (A.C.); (E.B.); (V.T.); (N.M.); (M.D.M.); (F.L.); (S.D.C.); (V.V.)
- Oncological and Reconstructive Maxillo—Facial Surgery Unit, Policlinico Umberto I, Viale del Policlinico 155, 00161 Rome, Italy;
| | - Edoardo Brauner
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome; Via Caserta 6, 00161 Rome, Italy; (A.C.); (E.B.); (V.T.); (N.M.); (M.D.M.); (F.L.); (S.D.C.); (V.V.)
- Implanto-Prosthetic Unit, Policlinico Umberto I, Viale Regina Elena 287b, 00161 Rome, Italy
| | - Resi Pucci
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome; Via Caserta 6, 00161 Rome, Italy; (A.C.); (E.B.); (V.T.); (N.M.); (M.D.M.); (F.L.); (S.D.C.); (V.V.)
- Correspondence: ; Tel.: +6-499-791-46; Fax: +6-499-791-49
| | - Valentina Terenzi
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome; Via Caserta 6, 00161 Rome, Italy; (A.C.); (E.B.); (V.T.); (N.M.); (M.D.M.); (F.L.); (S.D.C.); (V.V.)
| | - Nicolò Mangini
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome; Via Caserta 6, 00161 Rome, Italy; (A.C.); (E.B.); (V.T.); (N.M.); (M.D.M.); (F.L.); (S.D.C.); (V.V.)
| | - Andrea Battisti
- Oncological and Reconstructive Maxillo—Facial Surgery Unit, Policlinico Umberto I, Viale del Policlinico 155, 00161 Rome, Italy;
| | - Marco Della Monaca
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome; Via Caserta 6, 00161 Rome, Italy; (A.C.); (E.B.); (V.T.); (N.M.); (M.D.M.); (F.L.); (S.D.C.); (V.V.)
| | - Alessandro Ciolfi
- Private Practice, Studio Dentistico Ciolfi, via degli Elci 39, 00172 Rome, Italy;
| | - Federico Laudoni
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome; Via Caserta 6, 00161 Rome, Italy; (A.C.); (E.B.); (V.T.); (N.M.); (M.D.M.); (F.L.); (S.D.C.); (V.V.)
| | - Stefano Di Carlo
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome; Via Caserta 6, 00161 Rome, Italy; (A.C.); (E.B.); (V.T.); (N.M.); (M.D.M.); (F.L.); (S.D.C.); (V.V.)
- Implanto-Prosthetic Unit, Policlinico Umberto I, Viale Regina Elena 287b, 00161 Rome, Italy
| | - Valentino Valentini
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome; Via Caserta 6, 00161 Rome, Italy; (A.C.); (E.B.); (V.T.); (N.M.); (M.D.M.); (F.L.); (S.D.C.); (V.V.)
- Oncological and Reconstructive Maxillo—Facial Surgery Unit, Policlinico Umberto I, Viale del Policlinico 155, 00161 Rome, Italy;
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